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Comparison Of Hemodialysis And Peritoneal Dialysis Outcomes In The Older Patient Population, Dane Rasmussen

Physician Assistant Scholarly Project Papers

The objective of this research and systematic literature review is to determine the dialysis modality of choice for elderly patients with end-stage renal disease. This literature review will compare the outcomes of hemodialysis and peritoneal dialysis, which will be judged by morbidity, mortality, and quality of life. In this review, PubMed, Embase, and DynaMed were searched using a specific set of keywords and mesh headings. Results of the searches were then filtered to include human-only studies, patients over 65 years old, and published within the last ten years. There were 12 studies that met inclusion criteria and were selected for …

Chronic Kidney Disease From Non-Traditional Causes Throughout Central America, Abigail K. Watson

Senior Theses

Throughout many Central American countries, incidence of chronic kidney disease (CKD) has been on the rise. The disease mainly affects agricultural workers and differs from typical CKD. Patients in these countries often do not have preexisting conditions such as diabetes or hypertension known to be traditional causes of CKD. They also experience increased damage to the kidney tubules, rather than the glomeruli generally more heavily impacted. There has been speculation regarding the causes of CKDnT (chronic kidney disease of nontraditional causes), but no consensus has been reached. Two major hypotheses to explain the high prevalence among Central American sugarcane workers …

Numerical Model To Predict Hemolysis And Transport In A Membrane-Based Microfluidic Device, Matthew D. Poskus

Theses

Microfluidics has become an increasingly popular tool in the design and development of medical devices and artificial organs. Two promising applications of microfluidics are dialyzers and oxygenators. As a step toward portable dialysis treatment, continuous microfluidic dialysis may resolve many clinical issues with current dialysis treatments. Additionally, commercially available oxygenators exceed the blood volume of neonatal patients; low-volume microfluidic devices may safely deliver oxygen to these patients. Two critical parameters in the development of these devices is mechanical hemolysis and membrane diffusion, which are intricately connected to the geometry, flow rate, properties of the membrane, and each other. A computational …

Understanding Social Support Among Dialysis Patients: A Study On Medical Social Workers Enhancing Social Support For Patients, Brandy Marie Covarrubias, Eloisa Cisneros Vizcaya

Electronic Theses, Projects, and Dissertations

Patients receiving dialysis treatment experience immense changes in their health and well-being, therefore receiving adequate social support services is an integral aspect of their care plan. Thus, the purpose of this study was to gain an understanding about social support services offered by social workers to patients receiving dialysis care. Furthermore, this study sought to develop awareness about additional services need to assist social workers in providing social, emotional, and physical support to patients. This qualitative study used data from a non-probability snowball sample of 10 social workers that work with patients receiving dialysis care. Findings of this study are …

Reducing Hospital Readmission Rates Via Np- Initiated Post Discharge Telephone Calls In Dialysis Dependent End Stage Renal Disease Patients, Fabiola Carapia

Doctor of Nursing Practice Final Manuscripts

Purpose/Aim:To determine whether a nurse practitioner-initiated phone call, in addition to the standard transition-of-care (TOC) protocol, will reduce 30-day hospital re-admissions by 50% in patients with end-stage renal disease (ESRD) after an inpatient index hospitalization.

Background: $27 billion is spent annually by Medicare for hospital readmissions. Approximately $17 billion of this amount can be attributed to avoidable causes (Kauffman, 2016). Hospitals have been penalized for excessive readmission rates under the Hospital Readmissions Reduction Program beginning in 2012 (HRRP; Centers for Medicare & Medicaid Services [CMS], n.d.). Index hospitalization refers to the first time, in a series of hospitalizations, that …

Ar Blockers, Emma Merlino, Charles Nelson, Brendan Laing

Honors Theses

Access Recirculation (AR) severely decreases the efficiency of dialysis while having the potential to lead to a variety of complications (Fig. 3). If recirculation occurs during treatment, the patient may be at risk of developing stenosis (narrowing of blood vessels), leading to thrombosis (the local coagulation/clotting of blood) [4]. The most influential cause of recirculation results from the misplacement of the arterial and venous needles that will significantly harm the patient, wasting both money and resources. It is clear that the medical community has focused their energy on developing a proactive approach to monitoring AR, instead of preventing it. Creating …

Multiple Dimensions And Correlates Of Fatigue In Individuals On Hemodialysis: A Quantitative Study, Bincy Joshwa

Wayne State University Dissertations

Background: Fatigue is present in individuals on Hemodialysis (HD). Evidence on fatigue in HD are limited by focus on unidimensional aspect of fatigue, flawed unidimensional tools, lack of objective measures, and variability in the correlates of fatigue. Purpose: To examine severity and trajectory pattern of fatigue; delineate influencing physiological and situational factors pre-dialysis and post-dialysis. Theoretical Framework: The Theory of Unpleasant Symptoms was used to guide the study. Methodology: A descriptive, correlational, before-after design was utilized. Measures were Piper Fatigue Scale (PFS)-12, Patient Reported Outcomes Measurement Information Systems (PROMIS)-Fatigue, Charlson Comorbidity Index and six-minute walk test (6MWT). Adults, cognitively intact …

Role Of Dyslipidemia On Lipid Metabolism In Maintenance Hemodialysis Patients, Eno Latifi

Wayne State University Dissertations

Maintenance hemodialysis (MHD) patients experience various abnormalities such as systemic inflammation (SI), oxidative stress (OS), and dyslipidemia (D). Defined as an imbalance of plasma lipids, lipoproteins, and lipid metabolism enzymes, D has been associated with a rise in morbidity and mortality within ESRD patients due to cardiovascular disease (CVD). However, the contribution of each of these parameters to D is poorly understood; moreover, the impact of the following parameters on dyslipidemia in different ethnicities is unknown. Hence, the objective of this study was to characterize D in a multi-ethnic cohort of ESRD patients. We hypothesized that the degree of dyslipidemia …

Nursing Interventions For Intradialtyic Hypotension: Using Blood Volume Monitoring Guided Ultrafiltration, Suzette S. Cedeno

Honors Undergraduate Theses

Background: Intradialytic hypotension is a potential complication experienced by patients with end-stage renal disease who receive hemodialysis. This complication occurs during the dialysis treatment in 15-30% of all treatments. The multiple comorbidities that exist in hemodialysis patients predispose them to recurrent intradialytic hypotension episodes. Recurrent intradialytic hypotensive episodes can result in negative short-term and long-term clinical consequences. Short-term consequences include complications such as ischemic events (e.g., heart attacks, strokes), clotting of patient dialysis access, or heart rhythm abnormalities. Long-term consequences include end-organ damage, increased cardiovascular morbidity, and a higher mortality rate. Problem Statement: Available nursing interventions used to treat intradialytic …